Balance of life - the goldilocks effect
- Jayashree Gopal
e-mail: goplajayashree@yahoo.com

September 27, 2016

Everything in our body is balanced perfectly. Not too high or too fast, not too low or too slow. All things – just right. Imagine the perfect aramandi. An experienced dancer knows the exact angle at which to sit – too much and the symmetry is lost, and too little, it is not an aramandi. It is just right.

I am always struck by the parallels in our physiology. Take for example sugar – it has to be maintained between 70 – 120 mg/dl, and our body does this very elegantly. When we eat or are under stress, our blood sugar levels start to rise, and the signal immediately goes to the pancreas, which secretes hormones including insulin, and glucagon, which go into the blood stream, and exert their effects, so that the blood sugar almost immediately comes back into the normal range. Now imagine this happening EVERY single second of our life. It is a wonder that more of us do not develop diabetes, considering the abuse we throw at our pancreas right from birth.  We all know the problems that occur from having too high blood sugars – it affects the heart, the kidney, the eyes, the nerves, the brain – everything in our body works less effectively when blood sugars are too high.

But, here is the beauty – too low blood sugars are also bad. As soon as the blood sugars start dipping below 70 mg/dl, immediate protective mechanisms come into play that start pushing the blood sugars back up. The healthy pancreas takes care of high and low blood sugars effortlessly, in an elegant symphony where all the players know their parts, and synchrony is achieved. The ill effects of too low blood sugars (did you know frequent low blood sugars also increase the risk of a heart attack?) has been better understood in the past 10-15 years. This was after studies showed that people with diabetes who maintained their blood sugar under “too tight” control were doing so at the expense of frequent, unrecognized low blood sugar episodes, which in turn was actually causing them to develop more problems.

The management of diabetes has therefore taken a paradigm shift in the last five – seven years. No longer do we try and push the blood sugars in to the “normal” range for all people. We decide what is a safe target for each person, and try and achieve that.
Another shift in diabetes management is to do with the smoothness of blood sugar control. Blood sugars that careen wildly between 80 and 400 mg/dl in the same person in a short period of time is bad. BS that is maintained between 150-200 mg/dl in a smooth manner may be much better for this person in the long term.

Take another example – fat. Again, popular opinion is that too much fat is bad, and this is true for the most part. Excess fat in the body increases risk of diabetes, high cholesterol, high blood pressure, arthritis, certain cancers – the list is very long. But too little fat in the body is also hazardous to health. For a start, girls need to have a certain minimum amount of body fat before they start puberty. Girls who are very thin due to anorexia may have a delayed start to their periods or may stop having their periods till they regain the body fat. Certain conditions where there is little or no body fat also causes diabetes and high cholesterol (the exact same problems as with too much fat!). Fat in our body has to be maintained between 15-25% of our body weight to achieve optimal metabolic balance. A third example – sodium. This salt in the blood has to be maintained between 135 and 145 meq/l. Values which are both higher and lower than this causes weakness, tiredness, nausea, vomiting, headaches and even seizures. The balance of sodium is maintained by a number of hormones that act in concert on our brain (to regulate thirst) and on the kidneys (to control water output).

A few other examples of the perfect goldilocks effect in our body – heart rate (normally between 60-90/minute), calcium (8.5 – 10.5 mg/dl) and breathing (12-20 breaths/minute). How about sleep – too much is also bad, and too little is also associated with many ill effects.

As I sit here writing this, I am struck by the perfect balance of millions of chemicals and hormones that is achieved at this instant and at every instant to help me do this simple task. It makes me offer thanks to the temple that is my body.



Dr.  Jayashree Gopal is a Senior Consultant in Diabetes and Endocrinology at Apollo Hospitals,  Chennai. She is also Consultant Endocrinologist and Diabetologist at the Seethapathy Clinic and the E V Kalyani Medical Center, Chennai. Dr. Gopal holds a Diplomate of the American Board of Internal Medicine as well as a Diplomate of the American Board of Endocrinology, Diabetes and Metabolism. Dr. Gopal is interested in gathering and compiling data on common Endocrine problems and on setting up an education program for the self-management of diabetes.
www.drjayashreegopal.com















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